Management Information system (MIS) has been defined by Weitkamp in his book ‘ Integrated Health Systems- logic, information and strategy- A Master’s Paper’ as ‘computer or linked computer systems designed to inform and enhance management decision making by providing integrated data from various and often distributed pertinent sources’. In a chapter on ‘Portable Health Administration’ he describes Healthcare MIS to focus mainly on financial and transactions related to revenue cycle and supply chain management in order to generate reports in lesser transaction time and more accuracy.
Earlier, hospitals outsourced these financial processes to financial services companies but as time changed and computers became more and more affordable, compact and a common mans tool, outsourcing was discouraged and newer functionalities were added to financial MIS tool to automate more departments like the registration, scheduling, administration, transfer and discharge and so on. Little automation also began of Laboratory, radiology and critical care units and a need for these standalone systems to talk to each other arose and healthcare MIS matured to healthcare MIS enterprise solutions called HIS.
An ideal healthcare MIS has been stated in the book to include ‘Various and distributed computer application linked for the longitudinal acquisition, verification, processing and analysis, archiving and sharing of patient focused data, integrated demographics, financial and clinical elements.
The purpose of HMIS according to the author is to automate core processes of healthcare delivery, minimize data inaccuracy and redundancy of data collection, connect & support caregivers and patient decision making with structured evidence based knowledge, improve health outcome, reduce medical error and lower cost. Huge amount of money has been invested in research, development and marketing of these HMIS. Result of this is hyped marketing of enterprise solutions that promise far more than they can deliver.
Continuous technological upgrades and advancements are difficult to cope with both by vendors and hospital in terms of development, implementation and upgrade cycle. People on both sides learn by trial and error. Those involved in selection of the product need not necessarily have technical expertise of computing platforms, RDBMS, interface engines, data capture, system design and international standards but must strategic intent and vision aligned with business model and culture and knowhow of capabilities of IT to transform healthcare delivery in terms of knowledge management and to improve patient care and safety.
Transformation management is the challenge in implementing these systems. The leadership must be able to manage this dramatic change in work progress, employee attitude, education, deployment, resource allocation and metrics of success and accountability for ensuring full implementation of enterprise wide HIS. A properly designed and implemented healthcare MIS has significant potential to abet cost-effective clinical management of diverse patient population across the entire spectrum of patient care.
Most HMIS aim to move away from paper based medical record to computerized patient record (CPR) or the Electronic patient record (EMR). These records improve capture, storage and retrieval of longitudinal patient data, enhance record legibility and improve portability by making the record available at the point of care and to multiple users simultaneously. The CPR serves as the electronic portal linking health care workers and patients not just to the patient chart and to each other but also to the vast portfolio of additional knowledge tools like the instant messenger, evidence based best practice guidelines and tools, professional continuing education, patient education tool and resources, preferred pharmacy formularies, open scheduling for tests and consults and many more.
The Table below from the book shows direct and indirect benefits of healthcare management information systems related to return on investment:
Table 1- Direct and Indirect benefits from HMIS
| Direct | Indirect |
| Reductions in personnel required to handle paper processes for both clinical and business functions, coupled with improved efficiency and productivity of remaining personnel through process engineering. | Enhanced organizational image, market share and ability to recruit and retain best and brightest employees. |
| Reduction in duplication and redundancy of data capture and chances of error | Improved corporate compliance with demands of regulatory agencies |
| Reduction of adverse drug events and other medical error | Diminished medical malpractice exposure |
| Improved preauthorization, charge capture and revenue cycle. | Enhanced employee satisfaction and facilitation of team management of patients across the continuum of care |
| Availability of uniform information to multiple users at multiple sites simultaneously | Enhanced negotiating positions with purchasers of service based on improved and more easily demonstrated quality and cost metrics- lower cost/discharge, higher preventive medicine compliance etc. |
| Improved adherence with cost-effective care protocols/ pathways and pharmaceutical formularies |
Enhanced patient satisfaction through improved organizational performance and ease of access to healthcare information and services |
| Improvement in management of supply chain, purchasing, inventory etc |
Book Reviewed-
Weitekamp, M.R ,1997 ‘ Integrated Health Systems- logic, information and strategy. A Master’s Paper’ Pennsylvania state university